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Emergency Drugs (Paramedic)
Medications for the prehospital emergency setting
16
Health Care
Advanced
10/12/2015

Additional Health Care Flashcards

 


 

Cards

Term

Albuterol (Proventil and Others)

 

class / description

 

Definition

Class: Sympathomimetic, bronchodilator, beta2 agonist

 

Description: 

sympathomymetic selective for beta2 - adrenergic receptors. 

 

Relaxes smooth muscles of the bronchial tree and peripheral vasculature by stimulating adrenergic resptors of the sympathetic nervous system.

Term

Albuterol (Proventil and Others)

 

 indication / onset / duration

Definition

Onset:  5-8 min. after inhalation

Duration:  2-6 hrs. after inhalation

 

Indications:

Relief of bronchospasm in pts with reversible obstructive airway disease

Prevention of exercise-induced bronchospasm

Anaphylaxis

Hyperkalemia

Term

Albuterol (Proventil and Others)

 

contraindications / adverse reactions

 

Definition

Contraindications: 

hypersensitivty to albuterol or levalbuteral

Cardiac dysrhythmias associated with tachycardia (precaution)

 

Adverse Reactions:

Usually dose-related, restlessness, apprehension, dizziness, palpitations, tachycardia, dysrhythmias, tremors

Term

Albuterol (Proventil and Others)

 

drug interactions

Definition

Drug Interactions: 

Other sympathomimetics may exacerbate adverse cardiovascualar effects.  1 symapthomimetic @ a time.

MAO inhibitors and trysyclic andtidepressants may protentiate effects on the vasculature (vasodilation)

Beta blockers may antagonize albuterol

Albuterol may potentiate diuretic-induced hypokalemia.

Term

Albuterol (Proventil and Others)

 

how supplied

Definition

How Supplied:  Metered-dose inhaler: 90 mcg/metered spray (17-g canister with 200 inhalations)

 

Solustion for Aerosolization:  0.5% (5 mg/mL);  0.083% (2.5 mg/mL) in 3-mL unit dose/nebulizer

Term

Albuterol (Proventil and Others)

 

dosage and administration adult

 

Definition

Dosage & Administration: 

Bronchial Asthma / Anaphylaxis / Hyperkalemia

 

Adult:  MDI 1-2 inhalations (90-180 mcg) q 4-6 hrs

(wait 5 min between inhalations) 

MAX 12 inhalations/day

 

Solution 2.5 mg (0.5 mL or 0.5% solution) diluted to 3 mL w/ 0.9% NS (0.083% solution); administer over 5-15 min; 3-4 times/day by nebulizer

 

Note:  In settings of severe asthma exacerbation,

4 inhalations or 5 mg in 2.5-3 mL is indicated

 

Term

Albuterol (Proventil and Others)

 

dosage and administration pediatrics

 

Definition

Pediatric:  MDI 4-8 puffs (inhalation) PRN,

w/ spacer if not intubated

 

Solution 0.01-0.03 mL (0.05-0.15 mg)/kg/dose to max of 0.5 mL/dose

diluted in 2 mL of 0.9% NS,

may be repeated q 20 min

 

Nebulized albuterol 

<20 kg:  2.5 mg/dose (inhalation);

>20 kg:  5 mg/dose (inhalation)

Term

Albuterol (Proventil and Others)

 

special considerations

Definition

Special Considerations: 

Preganacy safety category C

Albuterol may precipitate angina petoris and dysrhythmias

Albuterol should be used w/ caution in patients with diabetes mellitus, hyperthyroidism, prostatic hypertrophy, seizure disorder, or cardiovascular disorder.

In prehospital emergency care, albuterol should be administered only via inhalation

Term

Amiodarone (Cordarone)

 

class / description

Definition

Class:  Class III antidysrhythmic

 

Description:  antidysrhythmic agent w/ multiple mechanisms of action.  Prolongs the duration of the action potential and effective refractory periode, and when given short-term IV, probably includes noncompetitive beta-adrenergic receptor and calcium channel blocker activity.

Term

Amiodarone (Cordarone)

 

onset / duration / indication

Definition

Onset:  Within minutes

Duration:  Variable

 

Indications:  Initial tx and prophylaxis of frequently recurring V-Fib & hemodynamically unstable V-Tach in pts unresponsive to shock delivery, CPR, and vasopressors

Recurrent hemodynamically unstable VT

Tx of some stable atrial and ventricular dysrhythmias

Term

Amiodarone (Cordarone)

 

contraindications

Definition

Contraindications: 

 

Pulmonary congestion

Cardiogenic shock

2nd or 3rd degree AV block if no pacemaker is present

Bradycardia

Sensitivity to amiodarone or iodine

Term

Amiodarone (Cordarone)

 

adverse reactions

Definition

Adverse Reactions:

 

Hypotension

Headache

Dizziness

Bradycardia

Atrioventricular conduction abnormalities

Flushing

Abnormal salivation

Pain at IV site

Liver function abnormalities

CHF

Abnormal thyroid function

Term

Amiodarone (Cordarone)

 

drug interactions

Definition

May potentiate bradycardia and hypotension w/ beta

blockers and calsium channel blockers

May increase risk of atrioventricular block and hypotension

w/ calcium channel blockers

May increase anticoagulation effects of warfarin

May decrease metabolism and increase serum levels of

phenytoin, procainamide, quinidine, and theophyllines

Routine use in combination w/ drugs that prolong Q-T

interval is not recommended

Y-site incompatibilites w/ furosemide, heparin, and

sodium bicarbonate

Term

Amiodarone (Cordarone)

 

how supplied / adult administration

Definition

Supplied:  50 mg/mL vials

 

Adult:  Pulseless arrest unresponsive to CPR, shock, &

vasopressors - 300 mg IV/IO push.  If needed, second

dose of 150 mg IV/IO

 

Life threatening dysrhythmias:  Max cumulative dose - 2.2 g IV/24 hr.  May be given as rapid infusion 150 mg IV over first 10 min (15 mg/min) repeated every 10 min PRN.  Slow infusion - 360 mg IV over 6 hrs (1 mg/min).  Maintenance infusion - 540 mg IV over 18 hrs (0.5 mg/min)

Term

Amiodarone (Cordarone)

 

pediatric doseage & administration

Definition

Pediatric:  Refractory VF, pulseless VT - 5 mg/kg rapid

IV/IO bolus; can be repeated to total dose of 15 mg/kg (2.2 g in adolescents) IV per 24 hr;

Max single dose - 300 mg

 

Perfusing suprventricular and ventricular dysrhythmias - loading dose 5 mg/kg IV/IO over 20-60 min

(max single dose - 300 mg); can repeat to a max of 15 mg/kg (2.2 g in adolescents) per day IV

Term

Amiodarone (Cordarone)

 

special considerations

 

Definition

Special Considerations:

Pregnancy safety category D

Rapid infusion may cause hypotension

Continuous electrocardiogram monitoring is required

Slow infusion or discontinue if bradycardia or atrioventricular block occurs

Do not give with other drugs that prologn Q-T interval

(e.g. procainamide)

Maintain at room temperature and protect from excessive heat

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